21 April 2016 PRESENTATION AT NATIONAL THE PEER REVIEW FEEDBACK MEETING Feedback Report on February 2016 Peer Reviews NORTHERN CAPE DEPARTMENT OF HEALTH

Comments -September Meeting Gave proper insight to PPTICRM Teams of their role Gave a better understanding of the elements on the dashboard Could benchmark with other districts and provinces Clarify the relationship between Ideal clinic and NCS/ OHSC 2

Comments -December Meeting It gave: guidance on expectations for the peer reviews members an understanding of the geographical areas where they had to do assessments them the opportunity to establish initial contact with the district that they will review the opportunity to organize their teams well common understanding of certain dashboard elements the opportunity to give input to the dashboard and manual Negative: Proper feedback was not given in all districts to facilities, review teams and other PPTICRM members 3

Software Preparation Feedback for software preparation vary form satisfactory to good Instructions for logging in for capturing was clearly given and no major problems were experienced Some saw the software as easily accessible and straight forward Some groups felt they received the final version late and did not really had time to practice before hand; had to practice while capturing and that was time consuming Version updates were received where changes did occur Lesson learnt: Teams that do peer reviews must be comfortable with the tools and the capturing; become extremely time consuming if not accustomed with the tools and software 4

Communication to peer reviewers The majority felt that communication from National and Provincial coordinator to teams were good ( / telephonically) Good support from National through quality communication from Ms Steinhobel on a regular base One member indicated that communication did not flow to all team members ( role of district coordinator)- may be due to lack of access for all members; can be strengthened with What’s Up group 5

Logistics- Transport Shuttle: 3 Teams made use of a shuttle Very negative experience for the two Namaqua teams when it became known that they had to use the local taxi service from Springbok to Cape Town Travel agent was also not accommodating when problem was communicated Better to use car rental services instead of shuttle services 6

Logistics Issues/ Events - Transport Flight Tickets: No problems with flights; but flight details were communicated very late. In one case different flight arrangements for group that have to travel together; did get it resolved after many engagements with travel agent Car Hire: -In all cases, cars were received on time and was in good condition. -Two teams reported that the fuel card was originally not activated; it was however easily corrected. 7

Logistics Issues–Accommodation and Meals -Ruth Mompati/ Ngaka Modiri Molema- No bookings ; had to wait outside until payment was done( Taung and Vryburg). Only got place to sleep at 22:00. Travel agent not helpful at all. -Mangaung: Poor quality accommodation and meals; travel agent not willing to make changes. -Ruth Mompati: Not booked for ; no supper for the night -F.Dabi- Serious problems experienced with bookings in Frankfort. Had to wait for hours before bookings were finalized. Travel agent not reacting to problems when they are called. 8

Logistics Issues–Accommodation and Meals -Lunchpacks: 6 Reports indicated that no lunch pack were received for the week -One indicated it was received from Tuesday, but it was of poor quality and expensive 9

Support Host District- Support of contact person on arrival Xhariep-Well received. Welcome meeting by District Director and a well planned programme Mangaung/ Botshabello:Good; Excellent Lejweleputswa: Kind, friendly, got support- “In fact we enjoyed it and was as if we knew these people all along” Ruth Mompati/ Ngaka Modiri Molema- : Good F.Dabi- Sense of people shifting responsibility; staff grateful for guidance given; not good support 10

Support Host District- visit the facilities Xhariep- Accompanied by clinic supervisor and Health area manager daily.Was helpful, tactful, knowledgeable, but did not interfere Mangaung: Excellent Lejweleputswa: Very good; always escorted Ruth Mompati /Ngaka Modiri Molema- : Very supportive; accompanied to all facilities F. Dabi- Good in 1 sub-district, not in other. Staff were not really knowledgeable on ICRM. Expected more support. 11

Support- Facility Managers Xhariep- Accommodating and eager to learn, positive, prepared, motivated and keen to hear how they can improve Mangaung: Excellent, positive, prepared, motivated Lejweleputswa: Kind and cooperative; were welcomed and felt at home; support and cooperation good Ruth Mompati/ Ngaka Modiri Molema- : Very helpful, excellent, positive, prepared and motivated F.Dabi:Excellent, positive,motivated; but did get feeling that facility did not get the support from PPTICRM that they was suppose to get. Staff thankful for guidance that they received from review team. 12

Availability of resources for peer review Hard Copy of peer review instrument Info came late from National; but teams made hard copies and took it with to all districts that they were visiting Thus, was prepared from the beginning 13

Availability of resources for peer review Data Capture( Modem,SIM,data bundle,Network availability No Modems from National were received before or while teams did the review They were however requested to try and ensure that they have a back up if modems does not arrive in time Departmental and in many instances private modems, and data that they themselves has purchased, was use Disruptions in connection often happened; then have to re-capture and that is very time consuming Team Laptop crashed, no network at facilities and no modem; tried WI-fi at guesthouse, but network was not good; had to capture afterwards at office Recommendation: Connectivity even at facility level is urgently needed to ensure capturing of results on a regular base 14

Availability of resources Ideal Clinic Software( access, data upload, support) No problems encountered, user friendly Ronel’s s assisted a lot Was easy; captured on same day as when assessment was done and gave immediate feedback to facility and health area manager Some questions in checklist incorrect; did communicate this 15

What went well and should be part of future peer reviews Preparatory Phase Training on tools and capturing prior to assessments Interaction with host district prior to visit Software were of good standard ; National guidance always of good quality Provincial coordinator’s arrangements and support Air flights and car rentals- very few problems 16

What went well and should be part of future peer reviews During Review Host support was well done Meeting before and after assessments with District Manager and team Accommodation and food( in majority of cases) Results captured on day of assessment Coordinators should always be present to see gaps 17

What went wrong and should be improved Preparatory Phase Delivery of finalized tools were late; provide at beginning of financial year The changing of district coordinator caused confusion and lack of proper communication- Peer Review champion More training / training needed on the tool prior to assessments; teams must be well orientated and capable to capture before they start with review Transport and accommodation must be confirmed at least 3 days / 1w before departure All teams must be supplied with modems, SIM cards and data bundles at least 1 week prior to assessments Arrangements of lunch should be confirmed prior to departure 18

What went wrong and should be improved During review Data bundles/ modems must be available at least week prior to assessment Delivery of materials should be on time( tools Avoid late night travelling; possibility of including 3 rd member in team Logistics should be concluded at least one week before reviews and communicated to review teams; include ordering of lunch boxes Teams still did not had a common understanding of interpretation of elements; regular training and discussions needed Changes to checklist and software must not happen when already busy with the process Feedback to the facilities before uploading the data Set up a call centre( probably early in the morning) to address problems Some elements on hard copy different from system- correct 19

Other Comments Auditing of patient files- Questions to be aligned with PC 101 The exercise is necessary and has had the results that facilities get the support and attention they desperately need All PPTICRM members should be part of peer review; it amplifies and focusses the importance of ICRM Logistical arrangements need much to be desired. Travel agent need to communicate with team members Teams had no formal form of identification Were impressed by the involvement of the community in maintaining grounds in the absence of groundsman Only two reviewers per team, are too limited 20

Overall experience of peer review in general Bad: 25% due to logistical arrangements; arrived very late at accommodation, need 3 people per team. Travel agent of no assistance when problems occur. Good :75% Reasons: It was a learning curve, used as benchmark, Share knowledge with those being assessed to improve in some areas Copied good practices from each other Well organized District Manager and positive operational managers Gave insight on the way things are done in other districts and provinces Became aware that we all face the same challenges Wants to be part of peer reviews again Overall- Positive experience; have learned a lot 21

Thank You…. Until the next review 22